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HomeMy WebLinkAboutBP19-215PERMIT # SECTION tt TYPE OF WORK JOB LOCAPON_ FEE DATE DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING 144 INSULATION PLUMBING RGH PLUMBING GAS O SPRINKLER ELECTRIC s LOW -VOLT O ALARM AS BUILT O FINAL /u�✓ec� ��n�l� C I' TwDesHer §fer907-8H8 �Pa�-a�rv/, Me�ctgrw,a compo�n y �o7`I-0�3 JP�Rfo Efec+nc ComPan�u ER AF�PRQVALS April • 2 . IER VILLAGE OF RYE BROOK WESTCHES COUN'k`�', NEw YORx �,�/ �� No: 2-I-042 ,19t12 Certtf irate of ®rrupaurp 'This is to certify that a,uagar(qSLP of, RW k having duly filed an application on 0cob�r �3. 20 a�3 requesting a Certificate of Occupancy for the premises known as, Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: / .�Q Block: I Lot: , and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. /—/-0?J,5 , issued 20 ��� , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications,Use: Inn r- Construction: , for the following purposes: C' a "- F' 4&1 Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be made,nor s 11 the bu' ' be moved from one location to another until a permit to accomplish such change has ee ned in e i nspector. APR 2 9 2024 Building Inspector,Village of Rye Brook: Date: t 'Z For office use onl D LE BUILD ART ENT PERMIT# / —Q/5 VIL OF RYE Bk6OK ISSUEDVO-3—/ 9 OCT 2 3 2023 KING STRE YE BROOK,NE" YORK 10573 DATE: 9 FEE: ,& PAIo.S VILLAGE OF RYE BROOK ° BUIL ING DEPARTM T ERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION i44Frt44ittttiktfi#4i#Fifi►i44#tiitii#tfti4tiF4#fiiki4itttitf4iififiiff ki#tii#k4if#iifi#ii4#ftit44ikfifi}fifirtrtfi4i4titRi4ttit4#4#4k Address: 9 Elm Hill Drive Occupancy/Use: single family Parcel ID #: 135.50-1-47 Zone: R-12 Owner: Derek Sykes Address: 9 Elm Hill Drive, Rye Brook 10573 P.E./R.A. or Contractor: Herbster Construction Address: 108 Hobart Ave, Port Chester, NY 10573 Person in responsible charge: James Herbster Address: 108 Hobart Ave, Port Chester, NY 10573 Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: James Herbster being duly sworn,deposes and says that he/she resides at 108 Hobart Ave (Print Name of Applicant) (No.and Street) in Port Chester ,in the County of Westchester in the State of NY ,that (Cityrrown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S 62,500 for the construction or alteration of Kitchen Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. 't h Sworn to before me this ' Sworn to before me this d of c-lo tf , 20 day �C� , 20 Si ure of Property Owner Si ature of Applicant Dut-K Sy Pies f .iq Print Name of Property Owner Print Name of Applicant Notary Pub is Notary HERNANDO A—•-AR JOHN M SUOZZO Notary Public,State of New York NOTARY PUBLIC,STATE OF NEW YORK No.01 AG6357782 Registration No.01 SU6070919,, Qualified in Westchester County Qualified In Westchester County Commission Expires April 24,20� My Commission Expires March 11,202E �E BRC��, �c 1' 19a2•'i�O BUILDING DEPARTMENT ❑BUILDING INSPECTOR []ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street . Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:- �j Z vE DATE: Z - g - 2 pL Q ,/ PERMIT# P J'z�� ISSUED: I0-/3-f I SECT: 1-3S •SU BLOCK:LOT: 7 7 LOCATION: /'l le-S /-L OD 4 A L 7-,6 eA TIOW OCCUPANCY: Z ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED t REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas 14 L L D ❑ FUEL TANK � 1 I/�.S"<� t�y��� S �5���!'V/f✓(9 7'-i� ❑ FIRE SPRINKLER /i2 F /�C /y�✓C f Di(JT ��2� AkJ p( ❑ FINAL PLUMBING ❑ CROSS CONNECTION �� FINAL ❑ OTHER 41 ke neivP E BRC��, '9a2 BUILDING DEPARTMENT UILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - -- - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - ---- -- -- - ADDRESS. t DATE: 3 j _ 7 PERMIT#�� t ISSUED: I p .D 44ECT:��LOCK: LOT: LOCATION: l� Z��,�-`�V OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: OUGH PLUMBING -/ROUGH FRAMING jNSULATION /NATURAL GAS L.P.GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER i . _ i = N = j, N o w ■ O N N W N N x v W p W odad 0 v W en en V z a z ~ g O o i ^ z x O W O N '� Wgo IO2 in i m < CA 00W 14 H � w V O a W z Oct ON C) , � , N � � � z , Z J M M o a 3 o A ON :mu w ; a V z �r w N ■ f ,-� M z W z W 1-4Q " a wQ ' V a N o oZ H w w 04 WF A O zzS z Q+ oG V cg C cn w z H O off v W w z x ° o Ln V H W z a w � z .. a Z 4I � 04 a z BUILDING DEPARTMENT D H_V VILL�A X;E OF RYE BROOK �_ 938 KING 3 , ET RYE B� K oa ,NY 10573 FEBDOI 202 014) -0669, VILLAGE OF R BROOK OOK Www•ryebrook.on,, BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required \ FOR OFFICE USE ONLY BP EP#: Approval Date: FEB 0 1 2 24 Permit Fee: $ Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated,���"" c�� is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. 1.Address:q I1r1 %kk J 10523 SBL: 13S!SO -1 — L —7 Zone: 2.Property Owner: e( Address: 9 Elm 111It �_ Loth Nl low Phone#: 7r i(—S 3 7—c?5/ / Cell#: email: 3.Master Electrician/Licensed Installer: )Aufkt- Address: kegµ jle AV#-- fol /aft Lic. #:Phone#: 91'I f'/,�-l'�-qL/a --Cell#: email:�Y*0ekeLi W af3OL"()✓n Company Name:7�i mb ,J,QG� (un*jA.l Address: IoSsb 4.Proposed Electrical Work/Fixture Count: 6 \ 5.31 Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: t�" ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the%AfA_<,� for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this Sworn to before m this 3 i day of ,20 day of ZC*v ,20 PLq Signature of Property Owner Signatur6 of Applicant Print Name of Property Owner FELICITY FULLER Print N Applicant Notary Public-State of New York ? No.01FUS425939 Notary Public Qualified in Westchester County Notary Public IDiy Commission Expires 11/29/20AS__ 10/30/2023 STATE WIDE INSPECTION SERVICES, INC. 0•0 OFFICEPSWISNY.COM SWIS JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 • Office Use Elect. Permit# c)y Date O 1 /Z l , Bldg Permit# _I_ Sq Ft d v�' Plumbing Permit# ✓ Final Certificate# City/Village p` .> Zip Building Dept. County Address 1i Cross Street Section'5, Block Lot LI Owner Name/Address(If different than above) �)� Contact Number c e.1c �y �` ❑Basement ❑ 1st Fl. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect )unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation FEB — 1 20A VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at anytime of Inspection additional items have been Installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address C Cc (�'i Name License# 1 Date i 3Uj Signature Address Q City/State ! Zip Code Company t N Phone# I L r State Wide Inspection Services C-0 � FEB - 7 2024 1080 Main Street L^. Fishkill, NY 12524 _�__ 845 202-7224 Phone VILLAGE Or- i�V'r c _�i;=:I�_lOft 914-219-1062 Fax STATE WIDE INSPECTION SERVICES as%V 0 as BUILDING �`�." �rt--��,v'l l_�T Email: offiice((�swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Pinto Electrical Company, Inc Derek&Cassandra Sykes Mark Pinto 9 Elm Hill Drive 109 Maple Avenue Rye Brook, NY 10573 Rye, NY 10573 Located at: 9 Elm Hill Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-023 135.50 1 47 Certificate Number:2024-0666 Building Permit Number: BP 19-215 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 9 Elm Hill Drive, Rye Brook, NY 10573 The Second Floor Kitchen& Family Room were inspected in accordance with the NYS and NFPA 70- 2017 and the detail of the installation,as set forth below,was found to be in compliance on the 5Th Day of February 2024. Name Quantity Rating Circuit Type Luminaires 34 Receptacles 16 Appliances 04 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. s ♦! Ln T O s TT o �`N N N N 4 A- 0 s y a ad C, ~ of ONO M m O W O o Ch � = r` _ cx z lowo r.w F... Q �„ • _ w s� _ z co ON V G� O Z Z ramQ C. G j °p Zj = Q ON z � 0 4 Zmmm c F w z yq a, � ° a W V F rp C cc QI col A.1 Z 25 f3 yE DRCv BUIL , 'IAV�1��AR. MENT D 1- VIL E OF RYE OK JAN -7 2020 938 KING ET RYE B ,NY 10573 (914) 939-5801 VILLAGE OF RYE BROOK or BUILDING DEPARTMENT ELECTRICAL RWIT APPLICATION Westchester Coun st 'r Electricians License Required ll)lt OFFICE l'51.: ()\1.1 131'#: EP#: 005 Approval Date: J AN 8 Permit Fee: $ le Approval Signature: Other: Disapproved• (fees are non-refundable) Application dated, �M* -s hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures ,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. a 1.Address: -! ELM di SBL: 13S-50 — I'q? Zone: !Z 2.Property gr_ —"G K L S Address: L Llt'( 1 c- e g Phone#: ' - - 2 5T< Cell#: Rey' fy03 1 email:XR -,s yj,,Y '20.J•.��� 3.Master Electrician: MA Address: j lieA� n —rI cb Lic.#: ,� Phone#: o� Cell#: �{ c jl ( email try�y (,Je�fie CA L-- Company Name: V Address: 4.Proposed Electrical Work/Fixture Count: V 6 a i.S�-4 7 6 0"T'4d T S !2, c.c Gr„lrs 8 ********************************************************************************************************* STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: I,�— I - � ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney.etc.) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Pr on&Building Code,'the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. wo o before me this O ~ t'`1 Sworn to before me this day o Geccr6Ptr ,20Iq day of 0 20 Z 0 gnature of Property Owner Si e f Applicant Print Name of Property Owner Print�N)ame of Applicant t/ # � � K ar Dt ct Nota blic _.�- ROSEANN G. BAWPublic MAYH.KR PALANI NOTARY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC,STATE OF NEW YORK N o. O 1 BA62 8093 4 I Registration No.O1KR6247681 Qualified In Westchester County QuaNed In Queens County11 Commission Expires August 29,2023 My Commission Expires May 13, 20 3/21/19 pcL Westchester �? 547�-3595 c ester Rockland Electrical Inspection Services, Inc. ,_ Phone: 914-3 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Elmsford NY 10523 r`' � ILDING ER IT NO. TEMP# DATE '� CITY OR VILLAGE 1 �JIP��Q)p TOWNSHIP _ COU STKE)AN - ROAD / Bdr BETWEEN WRKT TWO'CAOdS STfIEETS IS PREMISES LOCATED? ON �" BLOC r OCC r NAME\C ��C� BU 1LDI�U Y OWNER'S NAME AND ADDRESS I E TELEPHONE NUMBER 171 CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE NO. H.P.EACH NO. WATTS EACH INSPECTION OUTSIDE BASEMENT 1"FL. ini ifji., 7-FL. 3�FL. VILLA E OF YE B`Rt REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DEPARTMENT THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED. IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY.WREIS,INC. IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION. SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW❑ ADDITIONAL❑ EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS I _IDENTIFICATION NUMBER ❑ SERVICE ENTERS BUILDING OVERHEAD UNDERGROUND D /!1 1010 AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY DATE OF APPUCAT � SIGNATURE OP�ICANT L (2« 1 1 — c/ 6d C. X _. STR TELEPHONE No. � dn qi-47--+n,�-2�7 IVAI-k Cm OR POST OFFICE tC•r L LK:ENSE No.WHEN APPLJCASLE ■ o O N N z O � T E... LA Mo � - 1.0 00> co EA . m a A az x � a o BUILD t DEPARTMENT VIL E OF RYE BROOK I 938 KIN ET RYE BI�Q K,NY 10573 FEB — 5 2020 (914)9 6A1 AXC�1� 939-5801 VILLAGE OF RYE BROOK o org BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION I,OR OFFICE USE ONLY BI' #: � -0 1 � PP#: o" 0 Approval Date: FEB — 5 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated --n lQoao is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below. The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal, State,County/and Local Codes. I.Address: 1 ��ly �r /L­ (/_% -W';(e 'YWOX SBL: /3SS� ' l ^ ',Y 7 Zone: lFe Z 2.Proposed Work: VLJL = K' W&,2 Cd't' i(zh"JS�, !�c-L ItCi/L 3.Property Owner: P9 QAdC .S q4<<s Address: Q L 4kt f" �' �t/t-y nz' Phone#: 9/ly Cell 5"'60?i email:y� KS Y�4�slp' l cz�,/ •= T 4.MasterPlumber: �oSEPN YYI�L RG(�Aiv� Address: LvAUEQi (EVE . C A6 . D pJA;mAOc� Lie.#: IS,),( Phone#: Cell#'q I •-61 Ga'7 email: S"ELAC,RA�jar Grna1L• Cd� Company Name: L_A G i?A#-+r Cc. N Address: INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I'sst Floor q� 3`d Floor 41 Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: j`(La '') &A5 (Notarized Signatures Required Next 2 Pages) -1- 3/21/19 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: to C L.aGR-A,"y ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the Colar� g- for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. sus Sworn to before me this Sworn to before me this 5 dWature Ce M b c r 20 I q day of u 20� f Property Owner Si ature of Applicant Q ec-ek Sx K-e S S E-pI k iM F L A G �o Print Name of Property Owner Print Name of Applicant A &IL Notary PubM VIJAY H.KR PALANI NOTARKdPil�l10' It"TER0F NEW YORK NOTARY PUBLIC,B'fATE OF NEW YORK No.01 S16298688 Registration No.01KR6247681 Qualified in Westchester County Q11alitled in Queens County My Commission Expires March 17,2022 Commbsion FAPires August 29,2023 This application must be properly comp eted in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 3/2l/19 BUILDINV,DEPARTMENT D 1 VILL#E OF RYElBItOOK E 938 KING STET RYE BR o-k,NY 10573 FEB - 5 2020 (914)939 46$_ (914);439-5801 iv'`� � '' VILLAGE OF RYE BROOK �VWtiV. Ol`: Fa BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 31, 12„K S q K,'es , residing at, C1 �L K //'y' 7z -1 r.4 (Print name (Address where you live) being duly sworn, deposes and states that (s)he is the applicant above named, and further states that (s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; �G4t W' C"_ Z) R,1/..' , Rye Brook, NY. Doh Address) Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or ' nr ion of any kind into the sanitary sewer from the subject property in accordance with all State, Count d Vill ge Codes. '7 i-e of I'ropeiTy Owner(s)) (Print Name ol'Property Owner(s)) Sworn to before me this (0+ day of 20 I�l (Notary P (c) VIJAY H.KR3PALANI NOTARY PUBLIC,STATE OF NEW YORK Registration No.OIKR6247681 Qualified in Queens County Commission Expires August 29,2023 -3- 3/21/19 4 Building Permit Check List&Zoning Analysis Address: l �L�►M ( L l� 2 SBL: Zone: 1"Z- Use: 2 l o Const.Typed731� Other. Submittal Date: Z Revisions Submittal Dates: Applicant: ��R_S Nature of Work: �j{zt-,� W I ti►-1>o S �GU rL 1 T • t4 LT Reviews:ZBA: 8 2019 PB: BOT: Other. NEED OK (- ( ) FEES:Filing. S' BP: C/O: Legalization: ( ) (a/APP: Date Stamped�LProperly Signed `SSL Verified: H.O.A.Approval• ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Shore Fees: N/A.- SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current: Archival• Sealed. Unacceptable: ( ) V PLANS Date tam :ped: /' Seale `" Copies: 7— Electronic: Other.License Workers Comp: V Liability: Ne"' Comp.Waiver. Other. ( ) ( ) CODE 7S3#: Dated N/A: (. Y ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. FIRE ALARM/SMOKE DETECTORS:Plans: Permit: RW.I.C.:_Battery._Other. (� ( ) PLUMBING Plans: Permit: Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H V.A.C.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) ( ) 20I6 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER C/O DENIAL LETTER: Other. Other. (�mtg.date:. �c� approval:- I t,7 I t 9 notes: ( )ZBA mtg.date: �—approval: notes: ( )PB mtg.date: approval:- notes: APPROVED Area. REQUIRED EXISTING PROPOSED NOTES A p R 2 3 2019 Circle: &g1itage Front Front Sides: Rear. Main Cov Accs.Cor. Ft H Sb: Sd.H Sb: GFA: Tot.in: FG ImD: Height/Stories: notes: BUILD MENT E C E WLS VIL o»R '° OK MAR 938 KING >iYt '$h ,NY 10573 E720]19 ::... (914)9 `' 39-5801 VILLAGE OF RYE BROOK o re BUILDING DEPARTMENT ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS This form must be completed and signed by the applicant of record and a copy shall be submitted to the Building Department prior to attending the ARB meeting. Applicants failing to submit a copy of this check list will be removed from the ARB agenda. Job Address: aH N7 fo..L tt),2-f ve Phone# Parcel ID#: 135.�L-1-14_7 Zone: Z Date of Submission: Proposed Improvement(Describe in detail): APPIACANT CHECK LIST: 96r ° �l,T��� (N t T�-t The following items must be submitted to the Building W M ppv �'� ,1f3e= AT p_iL,rt'f Si(�c Departn lit with the application-no exceptions. ° 1. Z m leted Application FisNr-OucYt U�t-ri+St 0 E !.(�-rl�-� ( P pp a � 2. (�,�wo(2)sets of sealed plans. (one full size(maximum Property Owner: allowable plan size—36"x 42") and one I l"x I7") Address: L�LM I-h U . I)R- of5 3. ( )Two(2)copies of the property survey. 4. ( wo(2)copies of the proposed site plan. Phone#_�q 14)r,'3-7- OR S 1 5. ( One electronic/disc copy of the complete application materials. Applicant appearing before the Board: 6. (ti,/�Filing Fee. OHbN SL.fg--LPhT —,T(e—• 7. ( )Any supporting documentation. Address: 33 tNO A�-4 1h'1 —P-1)A.O ",).yi` N 8. ( )HOA approval letter.(fapplicable) IXWf 9. ( )Photographs. Phone#19 j,�-�Z`15-- -65-D 10.( )Samples of finishes/color•chart. (a sample board or model may be presented the might of the meeting) Architect/Engineer: .col-rrJ F SCytn �o �1 By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit Instructions&Procedures, and that their application is complete in all respects.The Board of Review reserves the right to refuse to hear any application not meeting the requirements contained herein. Sw to before me this Sworn to before me this YD M o rL,h , 20 I `� day of�\Gtc C , 20� e zz�of Property Owner gnature of Applicant ek Sykes Print Name ofProperty Owner Print Name of Applicant V.ru� J Nota l� Notary Public SHARI MELILLO VIJAY H.KRIPALANI Notary Public, State of New York Notary Public,State of New York No.01 ME6160063 No.01KR6247681 Oualified in Westchester County Qualified in Queens County Commission Exnires Januan' ,23. 20 Commission Expires August 29,2019 6/t/18 w VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 (T) 939-0668 (F) 939-5801 ARCHITECTURAL REVIEW BOARD Wednesday, April 17, 2019 NAME&LOCATION TYPE OF APPLICATION MOTION SECOND APPROVED REJECTED APPL.# 35 Country Ridge Dr New 617t Cedar Privacy Consent 4700 (Kaufman) Fence Agenda 2 Bonwit Road Amendment to prior Consent 4701 (Campbell) Approval (Change to Agenda Hardeplank Siding& Extend Eaves) 21 Long Ledge Dr New Windows 4702 (Little) 181 North Ridge St 1 Story Detached Garage 4703 (Conover/Figuera) Addition 44 Rock Ridge Dr Amendment To Prior 4704 Approval (Windows) 9 Elm Hill Drive New Windows, Front Door, 4705 (Sykes) Interior Alterations IM L (� 37 Hillandale Road Front Two Story Addition, 4706 (Fischer) Rear Open Veranda& Porch, Rear Deck, Patio, & Walks 7 Talcott Road Replace Existing RR Tie 4707 (Ambati) Wall w/Stone CMU 9 Maywood Ave New Rear Deck 4708 (Hyle) 18 Ridge Blvd Amendment to Prior 4709 (Pugilese) Approval (Portico) 6 Hunter Dr (Mutis) Rear 1 Story Addition& 4710 New Rear Deck 31 Longledge Dr Expand Upper Rear Deck& 4711 (Lazarus) Renovate Lower Deck ML NM MR SE JM SF AC MI JB 5 Garibaldi Place ( Legalize Deck Expansion& 4711 Quiles) Concrete Walk Side Of House To Rear 80 Windsor Road Replace & Expand Existing 4712 (Breen) Rear Deck ML NM MR SE JM SF AC MI JB Check List For Release of Building Permits Address: 1 0M 147 II)f-,,Ve-. Owner/Applicant: Qxlq,8 q-:� 0Z L-CN-Z-� Bccz Phone Ws: qk-?7- V ` 7' Dates Attempted To Contact Owner/ Applicant: 4M!V I q Comments: Sp1 6 4 GC 42�3w� Comments: sp kC -fo Cc Comments: NEED: ("/B uilding Permit Fee $ 945rLw-, ( ) PO # --T�'(1' atirnr- ( ) Fire Sprinkler Plans (2) ( ) Fire Sprinkler Application ( ) ire Sprinkler Permit Fee fire Cost $ ( ) SWO Fee $ ( ) Legalization Fee $ ( ) Other _ G) .� L L O c 'L 7 � N ; CD O UR.4. �.. o iF' s �•+•/ L" � v iotecti o n �M 0 e •4 �. 1r n' `Q !G Lu loj uj Z• o c r w is edaQ m � o '' G� 4� W QQ � + ' O u1 -o 0 tL4 U)LLJ y U L co r T � \c � O z c- G v. u 0 c t C O a, V < ' � U mw ACC>s CERTIFICATE OF LIABILITY INSURANCE DATE /22/2019/YI o3�z2izol s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Customer Service Department Gaslamp Insurance Services PHCONE No E■ (800)920-4125 F� NO) (800)920-4107 IA,•MAIL certificates@premleragencyservices Corn ADDRESS 3238 Grey Hawk Ct INSURERISI AFFORDING COVERAGE NAIL a Carlsbad CA 92010 INSURER A. Interstate Fire&Casualty Co 22829 INSURED INSURER B James E Herbster Construction Co..Inc INSURER C P.O Box 153 INSURER D INSURER E. Rye NY 10580 INSURER F COVERAGES CERTIFICATE NUMBER: GL Master 18-19 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ILTR TYPE OF INSURANCE POLICY NUMBER MMMD MM'DDrYYM LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f 1.000,000 CLAIMS-MADE PREMISES Ea is occurrence, S 50'000 MED EXP(Any one person $ 5,000 A MXC07012877 11,3012018 11/30t2019 PERSONAL aADVINJURY s 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE S 2.000,000 X POLICY �PRO ❑ LOC PRODUCTS COMPIOPAGG S 1,000,000 JECT OTHER Employee Benefits S MBINED SINGLE LIMIT S EAUTOMOBILE LIABILITY jCOa acadent ANY AUTO BODILY INJURY fper penwnl f OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per xcMenb S HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per acadenr f UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION pER OTN- AND EMPLOYERS'LIABILITY Y N STATUTE ER ANY PROP RI E T ORIPARTNERIEXECU TIVE ❑ OFF ICERIMEMBER EXCLUDED? NIA E L.EACH ACCIDENT $ (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ I'ves desrnbeunder DESCRIPTION OF OPERATIONS Debi E L.DISEASE POLICY LIMIT S DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101 Additional Remarks Schedule may be attached N more space is rpuired) Venficatlon of Coverage 'Subject to all policy terms,exclusions and conditions' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS 938 King St. AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 J 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund 199 CHURCH STREET,NEW YORK,N.Y.10007-1100 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) E�H `7 133113894 thh lw =a ^^^^^^ ���,�� JAMES E HERBSTER CONSTRUCTION CO.. INC. PO BOX 153 RYE NY 10580 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER JAMES E HERBSTER CONSTRUCTION CO., VILLAGE OF RYE BROOK INC. 938 KING ST PO BOX 153 RYE BROOK NY 10573 RYE NY 10580 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1050 098-1 369115 06/29/2019 TO 06/29/2020 10/2/2019 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1050 098-1, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK. EXCEPT AS INDICATED BELOW. AND. WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY.INCLUDING ANY NOTIFICATION OF CANCELLATIONS. OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COMICERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. JAMES E.HERBSTER OF JAMES E HERBSTER CONSTRUCTION CORP T/A BEAVER HOME REPAIR A/T/A BEAVER BUILDING REPAIR&MAINTENANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. BY CAUSING THIS CERTIFICATE TO BE ISSUED TO THE CERTIFICATE HOLDER, THE POLICYHOLDER UNDERTAKES TO PROVIDE THE CERTIFICATE HOLDER 10 CALENDAR DAYS' NOTICE OF ANY CANCELLATION OF THE POLICY. 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